[Prognostic significance of juvenile chronic arthritis onset types]

Juvenile chronic arthritis (JCA) is a disease or a group of diseases with chronic nonsuportive connective tissue inflammation. Depending of the onset of the disease and its course in the first six months there are three major types: systemic, poliyarticular and pauciarticular disease. Indicators of bad prognosis were: systemic form with signs of inflammation in the first six months, poliarticular onset and course, RF positivity, positive ANA and eye involvement. In the period from 1996 to 2002 at the Cardiology-Rheumatology Department in Sarajevo Pediatric Clinic 63 patients were addmited. Out of this 49 (78%) were new cases JCA was more frequent among school age girls 35 (57%). Systemic--onset JCA 9 patients (14%), polyarticular onset 19 patients (30%), pauciarticular onset 35 (55%). 15 (23.8%) was RF (rheumatoid factor) negative, 4 (6.3%) RF positive. Pauciarticular forms type 1 were 20 (31.7%), type II were 15 (23.8%). In 11 (17.5%) patients laboratory tests and clinical signs indicated poor prognosis. All patients with indicators of poor prognosis needed more aggressive therapy. Although JCA is the most frequent rheumatic disease and the leading cause of invalidity, and one of the most frequent chronic disease in children, we still do not know enough. The optimal treatment is still a challenge especially onset of JCA with poor prognosis.